Malawi + 3 more

C-SAFE: HIV/AIDS and Nutrition Newsletter - Issue 1, Sep 2003

Format
Situation Report
Source
Posted
Originally published
NEWS FROM THE FIELD
CRS Zambia wins USAID RFA

CRS Zambia has little time to celebrate, as they scale up for the rapid implementation of a new USAID project "Scaling Up Community Care for Social Safety Nets" (SUCCESS). This $1.7 million / 2 year project will build on existing strengths and partnerships in home-based care delivery with the Catholic Dioceses of Mongu and Solwezi, extending into new territory with the Dioceses of Mansa and Mpika. SUCCESS will strengthen and scale up traditional HBC service as well as train youth into HBC service provision. It also incorporates an IGA strategy aimed at improving livelihoods and income security for PLHA through Positive Living clubs. SUCCESS is precisely the kind of programming that informs C-SAFE's work in the field - we look forward to hearing more from CRS as implementation gets off the ground. For more information, contact Linda Lovick at lblovick@zamnet.zm.

Consortium in Malawi forms Working Group for The Chronically Ill

In May the Consortium members in Malawi met to discuss the formation of a working group that would look at the crosscutting theme of HIV/AIDS in C-SAFE's interventions. Referred to as the "The Chronically Ill Working Group", this group will monitor the effective implementation of vulnerability reduction and resilience strengthening methods. It will also give feedback on experiences in addressing food insecurity/ livelihoods in the HIV/AIDS context (type of interventions, targeting, who was involved, lessons learned etc).

Terms of reference for The Chronically Ill Working Group are:

  • Develop guidelines for targeting of the chronically ill in C-SAFE
  • Monitor the impact of intervention and documentation of implementation strategies
  • Promote involvement of communities in support of vulnerable groups
  • Promote linkages with C-SAFE NGOs, other NGOs and national AIDS networks
  • Organize frequent meetings to ensure sharing of experience and lessons learned among C-SAFE NGOs and other NGOs (bi-weekly meetings and ad hoc meetings)
  • Promote linkages and coordination with other C-SAFE working groups (FFW and SFP), WFP EMOP and NAC
  • Draw on the experiences of NGOs, UN agencies and national AIDS networks in dealing with HIV/AIDS
  • Ensure consistency in implementation approaches
If you would like further information, on this initiative, kindly contact Clara Hagens (chagens@care.org).

World Vision Zimbabwe to team up with Population Services International (PSI)

A pilot program has been initiated in three World Vision districts to integrate HIV prevention programming into food distributions. PSI brings a wealth of experience in social marketing and behavior change communication, and will work hand-in-hand with WV staff at Food Distribution Points. Taking advantage of having people congregate to receive food, this strategy uses drama and song to present monthly messages about prevention of HIV/AIDS. PSI initiated the process by getting the blessing of 'local influencers' (chiefs, headmen and District AIDS Committees) to smooth the way for implementation. Training of local implementers took place in June, and the results are now beginning to roll in. For lessons learned, please contact Mercy Hatendi at WVI Zimbabwe (mercy=5Fhatendi@wvi.org).

HOT OFF THE PRESS

New WTO Ruling Allow Poorer Nations to Import Generic Medicines (Aug 31, 2003)

The World Trade Organization has agreed to give poorer nations greater access to inexpensive life-saving medicine by altering international trade rules. Under the accord, poor countries will be able to import generic versions of expensive patented medicines, buying them from countries like India and Brazil without running afoul of trade laws protecting patent rights.

African countries and their supporters in nonprofit health groups have been campaigning for such an agreement for years, saying that moral and political arguments outweigh commercial considerations in the face of epidemics like AIDS, malaria and tuberculosis. The agreement had been held up by the Bush administration (under pressure from the powerful American pharmaceutical lobby) which has finally agreed that generic medications can be imported to deal with life-threatening diseases, as long as they are considered a public health emergency.

The countries most affected by the agreement were in the forefront of the lobbying efforts. India and Brazil, which manufacture cheap generic medicines, and South Africa and Kenya, nations that need them, pleaded with delegates late into the evening last night.

While UNAIDS has publicly welcomed the announcement, there is emerging speculation that this is a short-term win which has come too late and is not going to make a significant contribution when weighed in against the actual need. Some trade analysts believe the deal will be unable to provide the quantities of drugs needed while others have identified the agreement as a threat to the development of new drugs that will inevitably be needed in the developing world.

South Africa Announces Decision to Launch National Antiretroviral Treatment Program (July 11, 2003)

This announcement has been welcomed not only in South Africa but around the world. South Africa's response to AIDS now enters a critical new phase - one that is characterized by strong political commitment, a dynamic grassroots movement, more funding, and scaling up of prevention and treatment programs. This new national initiative will make that country's fight against AIDS truly comprehensive, with treatment complementing prevention efforts. Its implementation will bring hope for millions of people living with HIV, and their families.

Phase II Trial With PRO 2000 to Prevent HIV Transmission Begins in Africa

Women's Health Weekly July 7, 2003

Indevus Pharmaceuticals Inc. announced the initiation of a phase II clinical trial in Kampala, Uganda, to assess the safety of PRO 2000, a topically administered vaginal microbicide designed to prevent HIV infection. The randomized, double-blind, placebo-controlled trial, funded by the European Commission, will enroll approximately 100 sexually active female volunteers to be treated for four weeks. Researchers will evaluate the safety of PRO 2000 during and at the end of the study, based on the presence of local genital effects and systemic abnormalities.

Conference Announcement: 11th International Conference for People Living with HIV/AIDS

"The Dawn of New Positive Leadership" (Kampala, Uganda; October 26-30, 2003)

The 11th International Conference for People Living with HIV/AIDS aims to be a turning point in the global response to the HIV epidemic. Hosted by the Global Network of People Living with HIV/AIDS (GNP+), the purpose of the Conference is to reposition the role of people living with HIV/AIDS as the leaders in the global response. The Conference will provide a platform for advocates for the implementation of the UNGASS Declaration of Commitment, the Global Fund to Fight HIV/AIDS, TB and Malaria, and the emergence of new initiatives at the national and community level. The Conference will also be an exciting learning process for new activists and recently diagnosed people, especially from Africa, where they can learn firsthand the best practices and know-how for responding to the epidemic. Registration deadline: September 15, 2003. For more information contact: GNP+, PO Box 11726, 1001 GS Amsterdam, The Netherlands; phone +31.20.423.4114, fax +31.20.423.4224, website:www.gnpplus.net.

ICASA: The 13th International Conference on AIDS & STIs in Africa (Nairobi, 21st-26th Sept. 2003).

The ICASA Conference is a forum where every two years African scientists, social leaders, political leaders and communities come together to share experiences and updates on the responses to the HIV/AIDS pandemic. The theme of this year's conference is "Access to Care: Challenges." In Africa, fewer than four percent of the people in need of ARVs are receiving the drugs. And fewer than ten percent of PLWHA have access to palliative care or treatment of opportunistic infections. While we are generally familiar with the constraints to the provision of treatment, ICASA provides a platform for the sharing of ideas, lessons, research findings specifically derived from the experience of HIV/AIDS in Africa.

While it is too late now to register, C-SAFE be very interested to hear from those who attend ICASA this year. We ask you to keep your ears open for information on nutrition, food security, Positive Living and integrating HIV/AIDS in emergency settings, and to provide us with a short write up when you get back. Please!

UPCOMING EVENTS

Gearing up for World AIDS Day

December 1st is World AIDS DAY and as Doras Chirwa (HIV Sector Coordinator) reports, CARE Zambia is already planning a number of activities lined up to commemorates the millions of lives lost and forever changed by AIDS. During that week CARE Zambia will have photo inserts placed in a couple daily newspapers. These photos, taken in Zambia, will show the impact the pandemic has had on society. They will also showcase the resilience of the human spirit and the collective capacity for change that exists amongst us. A photo exhibition with a "Positive Living" theme will also run at Lusaka's Manda Hill Shopping Center.

On World AIDS Day, a memorial service will be held at CARE House for those we have lost to AIDS. The exterior of CARE House will also be decorated with a huge red ribbon, an event which has now become a CARE tradition. Other activities for the day include the distribution of T-shirts with positive living messages to support CARE staff participation in the annual march through the City of Lusaka. Doras's advice for planning World AIDS Day? "Start planning early. It always sneaks up on you and becomes very stressful trying to schedule activities and procure things at the last minute!"

Please let us know what your agency will be doing in preparation for World AIDS Day - stay tuned for the announcement of this year's World AIDS Day theme, or check on www.worldaidsday.org !

Vulnerability and HIV/AIDS Assessments

A workshop to develop critical indicators. This event is sponsored by WFP, Unicef and UNAIDS, and will be held in Johannesburg Sept 9-11. Facilitators, presenters and participants will be drawn from the region and tasked to develop and agree global indicators that will eventually apply to all our work on HIV/AIDS. The results of this workshop will be presented at ICASA later in September.

Feature Topic

Nutrition For Managing Common (HIV/AIDS) Conditions

There are a number of symptoms that are associated with HIV/AIDS that affect food intake and nutritional status of an individual. Signs and symptoms can range from mild to severe; be temporary or persistent depending on the type and extent of infections. They also depend on the physical and mental health of the individual. It is important to treat the immediate source of the problem (e.g. oral thrush, mouth sores, and other infections). Below is a table of the more common symptoms and suggested ways to alleviate them.

Symptoms
Suggested strategy
Fever and loss of appetite Drink high energy, high protein liquids and fruit juice
Eat small portions of soft, preferred foods with a pleasing aroma and texture throughout the day
Eat nutritious snacks whenever possible
Drink liquids often
Sore mouth and throat Avoid citrus fruits, tomato and spicy foods
Avoid very sweet foods
Drink high energy, high protein liquids with a straw
Eat foods at room temperature or cooler
Eat thick, smooth foods such as pudding, porridge, mashed potato, mashed carrots or other non-acidic vegetables and fruits
Nausea and vomiting Eat small snacks throughout the day and avoid large meals
Eat crackers, toast and other plain dry foods
Avoid foods that have a strong aroma
Drink diluted fruit juices, other liquids and soup
Eat simple boiled foods such as porridge, potato, beans
Loose bowels Eat bananas, mashed fruits, soft rice, porridge
Eat smaller meals more often
Eliminate dairy products because they may aggravate the symptoms
Decrease high fat foods
Avoid foods with insoluble fiber (roughage)
Drink liquids often
Severe diarrhea Drink liquids frequently
Drink oral dehydration solution
Drink diluted juices
Eat bananas, mashed fruits, soft rice, porridge
Fatigue, lethargy Have someone pre-cook foods to avoid energy and time spent in preparation (care with re-heating)
Eat fresh fruits that don't require preparation
Eat snack foods often throughout the day
Drink high energy, high protein liquids
Set aside time each day for eating

* Excerpted from the Draft Edition of the WVI Zambia BASIC GUIDELINES ON NUTRITIONAL CARE & SUPPORT FOR PEOPLE LIVING WITH HIV/AIDS prepared by World Vision Zambia C-SAFE Nutrition Unit

So what's the scoop on Vitamin A?

Vitamin A supplementation programs in Southern Africa have reduced under 5 mortality by up to 23% and have been especially effective in reducing morbidity and mortality of children under five who are HIV positive. Vitamin A deficiency has been associated with higher maternal-child transmission of HIV and faster progression of HIV to AIDS . And traditionally, of course, Vitamin A has been associated with vision - Vitamin A deficiencies brings eye problems and night blindness. But recently, there have been a lot of rumors and speculation about various connections between Vitamin A and HIV/AIDS - does Vitamin A deficiency make a person more susceptible to contracting HIV? Do Vit A supplements for pregnant women reduce mother-to-child transmission (MTCT) of HIV? Can Vit A supplements help an HIV+ individual stay healthy longer? These are all good questions, but recent research is still inconclusive. However...

The prevalence of Vitamin A deficiency is very high in C-SAFE countries and our targeted population is likely to be among the worst hit. While early studies have not identified a definitive role for Vitamin A in the treatment or management of HIV or AIDS, it is useful to know how to maximize our access to Vitamin A. There are three ways to do this:

1. Supplementation programs often target the most vulnerable: children under five and lactating women

2. Fortification of food products, such as sugar, milk, and cereals, help the general population to increase their daily intake on a regular basis, as long as they have access to fortified products.

3. Dietary intake plays the most important role, however, in ensuring that Vitamin A is available to the body every day to keep stores up. Remember, Vitamin A is fat-soluble - fat/oil must be present in order for Vitamin A to be taken up and stored in the body.

Vitamin A at a Glance

SOURCES
FUNCTIONS
Meat and dairy products:eggs, liver and kidney, some fish, cheese, full-cream milk (when fortified) and breastmilk maintenance of mucous membranes, includingthose that line the mouth, lungs, digestive tract and reproductive organs
Orange/yellow veggies and fruits:Carrots, mangos, papaya, pumpkins, yellow sweet potatoes; turnip production of white blood cells
Dark green leafy vegetables, spinach, rape, cassava leaves, sweet potatoes leaves antioxidant, needed for the immunefunction and resistance to infection
good vision

Feature Topic Nutrition For Managing Common (HIV/AIDS) Conditions

There are a number of symptoms that are associated with HIV/AIDS that affect food intake and nutritional status of an individual. Signs and symptoms can range from mild to severe; be temporary or persistent depending on the type and extent of infections. They also depend on the physical and mental health of the individual. It is important to treat the immediate source of the problem (e.g. oral thrush, mouth sores, and other infections). Below is a table of the more common symptoms and suggested ways to alleviate them.

Symptoms
Suggested strategy
Fever and loss of appetite Drink high energy, high protein liquids and fruit juice
Eat small portions of soft, preferred foods with a pleasing aroma and texture throughout the day
Eat nutritious snacks whenever possible
Drink liquids often
Sore mouth and throat Avoid citrus fruits, tomato and spicy foods
Avoid very sweet foods
Drink high energy, high protein liquids with a straw
Eat foods at room temperature or cooler
Eat thick, smooth foods such as pudding, porridge, mashed potato, mashed carrots or other non-acidic vegetables and fruits
Nausea and vomiting Eat small snacks throughout the day and avoid large meals
Eat crackers, toast and other plain dry foods
Avoid foods that have a strong aroma
Drink diluted fruit juices, other liquids and soup
Eat simple boiled foods such as porridge, potato, beans
Loose bowels Eat bananas, mashed fruits, soft rice, porridge
Eat smaller meals more often
Eliminate dairy products because they may aggravate the symptoms
Decrease high fat foods
Avoid foods with insoluble fiber (roughage)
Drink liquids often
Severe diarrhea Drink liquids frequently
Drink oral dehydration solution
Drink diluted juices
Eat bananas, mashed fruits, soft rice, porridge
Fatigue, lethargy Have someone pre-cook foods to avoid energy and time spent in preparation (care with re-heating)
Eat fresh fruits that don't require preparation
Eat snack foods often throughout the day
Drink high energy, high protein liquids
=B7Set aside time each day for eating

* Excerpted from the Draft Edition of the WVI Zambia BASIC GUIDELINES ON NUTRITIONAL CARE & SUPPORT FOR PEOPLE LIVING WITH HIV/AIDS prepared by World Vision Zambia C-SAFE Nutrition Unit

So what's the scoop on Vitamin A?

Vitamin A supplementation programs in Southern Africa have reduced under 5 mortality by up to 23% and have been especially effective in reducing morbidity and mortality of children under five who are HIV positive. Vitamin A deficiency has been associated with higher maternal-child transmission of HIV and faster progression of HIV to AIDS . And traditionally, of course, Vitamin A has been associated with vision - Vitamin A deficiencies brings eye problems and night blindness. But recently, there have been a lot of rumors and speculation about various connections between Vitamin A and HIV/AIDS - does Vitamin A deficiency make a person more susceptible to contracting HIV? Do Vit A supplements for pregnant women reduce mother-to-child transmission (MTCT) of HIV? Can Vit A supplements help an HIV+ individual stay healthy longer? These are all good questions, but recent research is still inconclusive. However...

The prevalence of Vitamin A deficiency is very high in C-SAFE countries and our targeted population is likely to be among the worst hit. While early studies have not identified a definitive role for Vitamin A in the treatment or management of HIV or AIDS, it is useful to know how to maximize our access to Vitamin A. There are three ways to do this:

1. Supplementation programs often target the most vulnerable: children under five and lactating women

2. Fortification of food products, such as sugar, milk, and cereals, help the general population to increase their daily intake on a regular basis, as long as they have access to fortified products.

3. Dietary intake plays the most important role, however, in ensuring that Vitamin A is available to the body every day to keep stores up. Remember, Vitamin A is fat-soluble - fat/oil must be present in order for Vitamin A to be taken up and stored in the body.

Vitamin A at a Glance

SOURCES
FUNCTIONS
Meat and dairy products:eggs, liver and kidney, some fish, cheese, full-cream milk (when fortified) and breastmilk maintenance of mucous membranes, includingthose that line the mouth, lungs, digestive tract and reproductive organs
Orange/yellow veggies and fruits:Carrots, mangos, papaya, pumpkins, yellow sweet potatoes; turnip production of white blood cells
Dark green leafy vegetables, spinach, rape, cassava leaves, sweet potatoes leaves antioxidant, needed for the immunefunction and resistance to infection
good vision

Remember, Vitamin A absorption and storage in our bodies depends on the presence of fat or oil!

Clearly, Vitamin A is an essential component of a balanced diet and in order to best serve ourselves and our target communities, we must help to overcome the very high prevalence of Vitamin A deficiency in this region. The advantage of fat-soluble vitamins (Vitamins A, D, E and K) is that they can be stored in the body, unlike the water-soluble vitamins which are shed quickly from our bodies and must be eaten every day. But it's good practice to take in small amounts of all vitamins, every day, in order to keep our bodies in the best working order and therefore more able to fight off illnesses.

So what are the implications for C-SAFE programming? Firstly, find out about Vitamin A programs in your country or district:

1. What is the government's strategy on Vitamin A? Is there a national supplementation program?

2. If your government is engaged in supplementation, what is the coverage? Who is responsible for delivering this service in your district? Are Supplementation Campaigns attached to National Immunization Days or other events that C-SAFE could participate in at district level? What can you do to increase coverage in your district?

3. What foods in your country are fortified? Do your C-SAFE communities have access to these products? Are people aware of their added value? Is cash flow the major constraint, or is there anything else you can do to promote these products?

4. Are any of the C-SAFE commodities fortified? If not, is there any way that they could be?

5. Is your organization promoting any kind of Vitamin A initiative? Could you support them in their efforts in C-SAFE districts, or could you open a door for them to work more closely with you?

6. Do your beneficiaries have much access to Vitamin A rich foods? What can you do to enhance their access? While meat is generally expensive and unavailable to our target communities, can you do anything to promote the fruit and vegetable sources?

7. In the trainings you offer (agriculture, Home-based Care) do you discuss the value of Vitamin A? Do people know how to prepare foods that are high in Vitamin A? Do they eat meats like liver and kidney, when they are available?

The answers to some of these questions can help you to make better programming decisions. Please let us know if you discover a strategy or an intervention that seems to work!

SPEAKING A COMMON LANGUAGE

Have you ever noticed that as soon as you start doing something a bit new in your programming, you run up against a lot of terminology that you never heard before? And that everyone expects you to know it already?

Well, you're not alone! So in case you were feeling at bit lost, here is a collection of terms and acronyms that HIV and Nutrition people tend to throw around:

VCT? Voluntary Counseling and Testing: A process to assist people to determine their HIV status. All three words are important: a person volunteers freely to participate, receives professional pre- and post- test counseling, and undergoes reliable and confidential testing.

ARVs, ART or HAART? Good question but luckily, pretty much the same answer. Refers to the medications taken to combat the HIV virus: Anti-RetroViral drugs, Anti-Retroviral Therapy, and Highly Active Anti-Retroviral Therapy. The distinction is that ARVs can refer to any medication (alone or in combination) for HIV, ART is a more comprehensive (but less commonly used) term for therapy that goes beyond just access to medications, and HAART refers specifically to combinations of drugs used to combat HIV. HAART drugs are not different or better that ARVs. ART is sometimes used to describe a whole 'package ' (medications, labwork, good technical advice, psychosocial and spiritual support). We most often speak of ARVs here in Southern Africa and we generally mean a 'cocktail' or combination of at least three drugs, taken together.

Sexual debut? First sexual experience. Delaying sexual debut is part of a strong HIV prevention strategy.

Secondary virginity? Describes the state where someone may have technically 'lost their virginity' at an earlier age but is choosing now to wait for a permanent relationship.

ARC? AIDS Related Complex: the series or cluster of illnesses that indicate an HIV+ person is moving from having no symptoms to the full-blown AIDS stage of their illness. This is the period during which many people start to think about VCT.

PWA, PLWHA or PLHA? People With AIDS, People Living With HIV or AIDS, People Living with HIV or AIDS: the terminology has actually progressed as we became more experienced with HIV and AIDS, and the acronym simply reflects our evolving thinking. We started out with PWA, found it too limiting, moved to PLWHA and found it to be too long, and these days PLHA seems to be taking hold. Stay tuned for future developments!

OI? Opportunistic Infection: an infection with a micro-organism that does not ordinarily cause disease, but that becomes pathogenic in a person whose immune system is impaired, as by HIV infection.

Positive Living? An approach to life whereby people with HIV/AIDS maintain a positive attitude towards themselves, take action to improve their situation, actively learn about how to manage illnesses, continue to work and lead a normal life and approach the future positively with hope and determination (and not with despair, depression, guilt and self pity).

RPU HIV/AIDS and Nutrition HELPLINE

Need a quick answer to a technical question? Need a reference or a contact, and don't know where to find it? The HIV/AIDS and Nutrition Advisor might be able to help you - call, fax or email Kate on 27-11-679 3601 (office), 27-11-679 3597 (fax), 27-82 466 7651 (cell) or kate=5Fgreenaway@c-safe.org. We will do our best to find the answers you need and get them back to you quickly.
Don't be shy - it's what we're here for!

Shopping Mall

We will try to keep you informed about products and services relevant to your work: red ribbon badges, relevant videos, keychains, stickers, etc. Sometimes, funds come your way and you need to spend them quickly - we want to help you be prepared!

Hope House Skills Training Centre: Paper mache products, doormats, assorted red ribbon badges, batik and tie-and-dye cloth. Luanshya Road, Light Industrial Area, P O Box 37559 Lusaka, Zambia. Phone: +260-1-227085/7 or E-mail: hopekara@zamnet.zm

Network of Zambian People Living Positively (NZP+): beaded red ribbon badges. E-mail: napnzp@zamnet.zm

Media for Development Trust: clearinghouse for video, mostly produced in the region, dealing with a range of HIV/AIDS-related issues. Phone: +263 - 4 - 701323 / 4 or E-mail:lavinia@mfd.co.zw

ALANGIZI National Association of Zambia: Necklaces, earrings, waist beads, belts, baskets, bags, cups, mats and beaded car seat covers & anything else that can be made with a red ribbon logo. Located near Lusaka National Museum/Evelyn Hone College (in between Kariba and Kitchen Hostels). Cell: +260-97-802723/+260-95-708042

Alfred Kabengele: wire red ribbon badges Kalingalinga, Lusaka, Zambia. Cell: +260-97-865603

Rest of the World

Positive Art - a South African non-profit organization that seeks to highlight the challenges of the HIV/AIDS pandemic in a creative and non-conventional manner, through selling handmade local art with a 'red ribbon' theme. Wide range of products including badges, mugs, neckties etc. Tel: (+27) (0)12 392 0500, Fax (+27) (0)12 320 2414, Email: info@positiveart.org.za, website http://www.positiveart.co.za

National AIDS Trust - this UK-based organization is a clearing house for a range of items from the UK and around the world - badges, cards, stickers, posters, t-shirts, toolkits, leaflets etc. Email: wad.merchandise@nat.org.uk, website: www.nat.org.uk

If you want to order stuff from South Africa or other C-SAFE countries, the RPU can help facilitate payment and delivery - just let us have a specific order. And keep us up to date with where the best 'shopping' is so that we can profile your vendors!

IN THE LOOP: INFO SERVICES

E-mail Services and Internet Sites

List-serves and discussion groups are an easy way to stay in touch with what's going on in the world of HIV/AIDS. You simply sign up using your email address and articles/announcements show up in your Inbox! Some of the most relevant ones include:

1. Af-AIDS: An email service giving you news on AIDS in Africa, as it breaks. Subscribe on line at af-aids@healthdev.net

2. SAfAIDS: Southern African AIDS/HIV Information Dissemination Service, PO Box A509,17 Beveridge Road, Avondale, Harare; Zimbabwe, Phone 263-4-336193/4; Fax: 263-4-336195; E-mail: info@safaids.org.zw, Webiste: http://www.safaids.org.zw. Excellent newsletter available on line or by subscription.

3. ProNut-HIV: An email service for information-sharing specifically about nutrition and HIV/AIDS aimed at enhancing positive living. Subscribe by sending an email to majordomo@usa.healthnet.org. Leave the subject line blank and in the body of the email, write 'subscribe pro-nut hiv'. Some email address formats, like the WVI one, may initially bounce and require you to read the instructions you get back. If this is giving you trouble, you can either subscribe using another email address or ask someone in IT to help you -- it will work eventually but it's a bit tedious.

4. ENN Online: Emergency Nutrition Network with online and print newsletters intended to share technical information about emergencies and nutrition. Subscribe at http://www.ennonline.net

5. The Body Pro: A forum providing technical advice and exchange for health professional on HIV/AIDS. Subscribe at http://www.thebodypro.com

6. www.redribbon.co.za is an i